HUDSON ISO-NEB FILTERED NEBULIZER SYSTEM 1755

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,user f report with the FDA on 2017-05-24 for HUDSON ISO-NEB FILTERED NEBULIZER SYSTEM 1755 manufactured by Teleflex Medical.

Event Text Entries

[75823125] (b)(4). A visual, dimensional and functional inspection of the device involved in the complaint could not be conducted since the device or a picture of the alleged defect was not provided at the time of this report. A device history record review shows that the product was assembled and inspected according to our specifications. Customer complaint cannot be confirmed based only on the information provided, to perform an investigation and determine the source of defect reported it is necessary to evaluate the sample involved on this complaint. However material from our current inventory was functionally inspected and no issues were detected that can lead this customer complaint. Regarding similar complaints from this same issue a (b)(4) was generated in order to further investigate this issue. If the device sample becomes available at a later date this complaint will be updated.
Patient Sequence No: 1, Text Type: N, H10


[75823126] Customer complaint alleges that the staff reports the device with this lot number is defective. Customer alleges the device was tested, and "the neb just bubbled". Alleged malfunction reported as detected during pre-testing. No report of patient involvement. No report of patient harm or delay in treatment.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004365956-2017-00214
MDR Report Key6586999
Report SourceCOMPANY REPRESENTATIVE,USER F
Date Received2017-05-24
Date of Report2017-05-09
Date of Event2017-05-04
Date Mfgr Received2017-07-06
Device Manufacturer Date2017-02-15
Date Added to Maude2017-05-24
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactKATHARINE TARPLEY
Manufacturer Street3015 CARRINGTON MILL BLVD
Manufacturer CityMORRISVILLE NC 27560
Manufacturer CountryUS
Manufacturer Postal27560
Manufacturer Phone9194334854
Manufacturer G1TELEFLEX MEDICAL
Manufacturer StreetPARQUE INDUSTRIAL FINSA
Manufacturer CityNUEVO LAREDO 88275
Manufacturer CountryMX
Manufacturer Postal Code88275
Single Use3
Remedial ActionOT
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameHUDSON ISO-NEB FILTERED NEBULIZER SYSTEM
Generic NameNEBULIZER, MEDICINAL,NON-VENTILATORY
Product CodeCCQ
Date Received2017-05-24
Returned To Mfg2017-06-22
Catalog Number1755
Lot Number74B1702078
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerTELEFLEX MEDICAL
Manufacturer AddressRESEARCH TRIANGLE PARK NC


Patients

Patient NumberTreatmentOutcomeDate
10 2017-05-24

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